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Medical bills, in plain language

Key steps, official links, and sample letters. Free for everyone, no account needed.

Last reviewed: October 24, 2026

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Not legal or medical advice. This page shares general information and links to official government sites. Rules, deadlines, and fees change, and some depend on your state or plan. Always check your own bill, letter, or court papers, or talk with free legal aid through LawHelp.org.

Urgent first: if you have court papers, your wages are being taken, or you were denied care you need now, go straight to If you're being sued or Insurance denials and appeals.

Scam safety: If a call, text, email, or chat message says you owe a medical bill, don't tap its links or call its number. Call the number on your insurance card or on a paper bill you already have (relay: dial 711), and report scams at ReportFraud.ftc.gov.

  1. Surprise bills after emergency or out-of-network care

    Under the No Surprises Act (in effect since 2022), an out-of-network doctor who treats you in an emergency can usually bill you only your in-network share: what you'd pay an in-network doctor. The same protections cover care at in-network facilities and air ambulances. Details: CMS: No Surprises Act.

    • Don't pay the surprise amount yet. Ask for an itemized bill (a list of every charge) and your insurer's explanation of benefits (EOB), the statement showing what insurance paid.
    • Dispute the bill in writing and keep a copy.
    • Call the No Surprises Help Desk at 1-800-985-3059 (deaf or hard of hearing: dial 711 for relay), or submit a complaint to CMS.
    • Do it as soon as you can, and before the bill's due date.

  2. Bill much higher than your Good Faith Estimate

    If you're uninsured or paying yourself, you have a right to a Good Faith Estimate, a written price estimate before care. If the bill is $400 or more above it, you can use the federal patient-provider dispute process. Start within 120 days of the date on the bill. There is a $25 fee. Check the current amounts on CMS: Dispute a bill. Keep the estimate, ask for an itemized bill, and ask the provider to pause collection while you dispute.

  3. Medical debt on your credit report

    There is no federal law banning medical debt from credit reports. A CFPB rule that would have done that was vacated by a court on July 11, 2025. The three credit bureaus follow their own voluntary policy: they leave off paid medical debt, medical debt under $500, and medical debt less than a year old (Congressional Research Service, PDF).

    • Get your free reports at AnnualCreditReport.com.
    • If a medical debt is paid, under $500, less than a year old, or wrong, dispute it with each bureau. Some states protect you more.
    • Most negative entries drop off after 7 years (CFPB).

  4. Insurance denials and appeals

    You can appeal. An internal appeal asks your insurer to reconsider. An external review is when an independent reviewer decides.

    • Ask your doctor for a letter of medical necessity explaining why you need the care, and for a peer-to-peer review, where your doctor talks directly with the insurer's doctor.
    • File the internal appeal within 180 days of the denial (HealthCare.gov: Internal appeals). If waiting could seriously harm your health, mark it urgent. An urgent decision must come as fast as your condition requires, and within 4 business days.
    • If the final answer is no, send a written request for external review within 4 months after you receive the final denial. A fast (expedited) external review is decided within 72 hours (HealthCare.gov: External review). In urgent cases you can ask for it at the same time as the internal appeal.
    • Medicare has its own steps: Medicare claims, appeals and complaints.

  5. Debt collectors and old debts

    • Don't pay or promise anything on the phone. In some states, even a small payment can restart the clock on an old debt (CFPB: Old debts).
    • A collector must send you a written validation notice describing the debt. Dispute in writing within 30 days of getting it, and ask them to prove it (CFPB: What a collector must tell you).
    • A collector can't sue or threaten to sue over a debt past your state's time limit for suing (the statute of limitations).
    • If they pressure you, complain to the CFPB.

  6. If you're being sued

    Don't ignore court papers. If you don't respond, the court can enter a default judgment, meaning the other side wins automatically, and they may be able to take part of your wages. The deadline to answer is on your papers and can be short, so check it today. Contact free legal aid through LawHelp.org and file a written answer with the court. Possible defenses include making them prove you owe it and checking whether it's past the statute of limitations (CFPB: Sued by a debt collector).

  7. Charity care at nonprofit hospitals

    Nonprofit hospitals must have a written financial assistance policy and tell you about it. Each hospital decides who qualifies. If you qualify, they can't charge you more than they generally bill insured patients (IRS: Financial assistance policies).

    • Ask for the policy and application, or find them on the hospital's website. Apply even if you're unsure.
    • You can apply up to 240 days after the first bill after you leave the hospital.
    • The hospital can't take extraordinary collection actions, like lawsuits or credit reporting, for at least 120 days, or while your complete application is pending. It must give you written notice at least 30 days before any such action (IRS: Section 501(r)(6)).

  8. A family member's bills after death

    We're sorry for your loss. Usually you don't have to pay. Debts are paid from the person's estate, meaning whatever they left. Family members generally aren't personally responsible unless they co-signed, shared the account, or a state law applies, like community property for spouses. Collectors can't make you think you owe it from your own money (CFPB: Debts after a death).

    • Don't pay from your own money. Send the hospital a copy of the death certificate and the contact details of the executor, the person handling the estate.
    • If the person had Medicaid, ask the state about a hardship waiver from estate recovery (Medicaid.gov: Estate recovery).

  9. Help for deaf or hard-of-hearing people

    Under the ADA, providers must communicate effectively with you, including interpreters and written options (ADA.gov: Effective communication).

    • Dial 711 for free TTY or speech-to-speech relay. Captioned phone service and video relay (VRS, with an ASL interpreter) use their own apps or numbers (FCC: Relay services).
    • You can ask the billing office and insurer to handle everything by mail, email, or their online portal.
    • Medicare: 1-800-MEDICARE (TTY 1-877-486-2048) (Medicare: Talk to someone). No Surprises Help Desk: 1-800-985-3059 (dial 711 for relay).

  10. U.S. territories and employer self-funded plans

    Federal protections, like the No Surprises Act and appeal rights, cover many employer plans, including plans where the employer pays claims itself (U.S. Department of Labor: No Surprises Act). HealthCare.gov says plans in U.S. territories other than Puerto Rico may use the federal external review process (HealthCare.gov: External review). Which rules apply to your plan can be complicated, so:

    • Start with your denial letter. It must tell you how to request external review and by when.
    • Ask HR for your plan's Summary Plan Description, the booklet explaining its rules.
    • For help, call the U.S. Department of Labor's Employee Benefits Security Administration at 1-866-444-3272 (dial 711 for relay) (Ask EBSA).

  11. Black out private info before sharing a bill

    • Black out your Social Security number, date of birth, member or insurance ID, card numbers, and any diagnosis you don't want to share.
    • Mask account and claim numbers so only the last 4 digits show.
    • Keep the dates, provider names, billing codes, and dollar amounts. Those are what's needed to check the bill.

  12. Sample letters

    Fill in the brackets. Send letters in a way you can track, keep copies, and write down the date you sent them.

    Dispute a surprise bill

    [Your name]
[Address] · [Phone]
Account number: last 4 digits only [XXXX]
[Date]

[Provider or billing office name]
[Address from your bill]

Re: Bill dated [date] for care on [date of service]

I received a bill for $[amount] for [emergency / out-of-network]
care on [date]. I believe this bill violates the No Surprises Act,
which limits what I can be charged to my in-network cost-sharing.

Please send me an itemized bill, correct the balance to my
in-network amount, and pause any collection while this is reviewed.

Sincerely,
[Signature]
Enclosures: copy of bill; explanation of benefits (EOB)

    Ask a debt collector to validate a debt

    [Your name]
[Address]
Reference number: last 4 digits only [XXXX]
[Date]

[Collection agency name]
[Address from their letter]

Re: Debt you say I owe to [original provider]

I dispute this debt. Please send me proof that I owe it,
including the name of the original creditor, an itemized
statement of the amount, and proof that you have the right
to collect it.

Until you respond, please stop collection. Please contact me
only in writing at the address above.

This letter is not an admission that I owe this debt.

Sincerely,
[Signature]

    Ask a hospital for financial assistance

    [Your name]
[Address] · [Phone]
Account number: last 4 digits only [XXXX]
[Date]

[Hospital name], Billing Office
[Address]

Re: Financial assistance for care on [date of service]

Please send me your financial assistance policy and application.
I would like to apply for help with my bill of $[amount].

Please hold any collection action on this account while my
application is pending.

Sincerely,
[Signature]